Organization
WJL PODIATRY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE LEWIS DPM (DOCTOR)
(601) 355-0026
Entity
Organization
Contact information
Practice address
953 NORTH ST, JACKSON, MS 39202-2615
(601) 355-0026
(601) 355-0069
Mailing address
953 NORTH ST, JACKSON, MS 39202-2615
(601) 355-0026
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
80062
MS
Other
Enumeration date
07/21/2016
Last updated
03/28/2017
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